膳食补充剂用于儿童门诊治疗：一项横断面研究。

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2024-11-27 DOI:10.1016/j.clnesp.2024.11.033

Em Canh Pham , Tuong Vi Le Thi , Thanh Chi Le , Tien Minh Nguyen , Nam Tran Nguyen

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引用次数: 0

摘要

目的：膳食补充剂是儿童疾病治疗中常用的补充剂，但门诊膳食补充剂的过度使用和处方不当会对健康和治疗成本产生负面影响。本研究旨在评估DS在儿童门诊治疗中的应用。方法：本研究采用横断面描述性回顾性方法，对188,579例儿童门诊处方1年的资料进行分析。结果：在≤5岁的儿童患者中（63.48%）常使用ds，诊断呼吸道、感染性和胃肠道疾病（>50%）。DS费用占门诊处方总费用的比例较高（24.86%）。此外，儿童处方中含有一种DS产品的比例（88.16%）高于含有两种DS产品的比例（11.84%），主要成分为维生素D3（80.55%）、维生素B6（63.01%）、维生素B1（60.22%）、维生素B2（59.04%）和钙（51.0%）。大多数DS产品含有多种维生素（69.52%），其中含有≥5种维生素的DS占59.04%，含有2-4种维生素的DS占10.48%。此外，年龄（21.38%）、剂量（14.13%）、年龄和剂量（5.54%）不符合DS处方指南的主要是高处方DS（维生素-氨基酸-矿物质成分）的儿科患者。结论：由于DS属于非处方药组，医生可能不仔细考虑DS使用说明书中推荐年龄和最大剂量。因此，迫切需要制定国家公共政策来预防和控制DS的过度处方和不当处方。

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Dietary supplementation use for outpatient treatment in children: A cross-sectional study

Objective

Dietary supplements (DSs) are commonly used supplements among children to support disease treatment, however, overuse and inappropriate prescription of outpatient DS can negatively affect health and treatment costs. This study aimed to evaluate DS use in outpatient treatment in children.

Methods

The present study used a cross-sectional descriptive retrospective method based on data from 188,579 outpatient prescriptions of children for 1 year.

Results

DSs were commonly prescribed in pediatric patients ≤5 years old (63.48 %) with diagnosing respiratory, infectious, and gastrointestinal diseases (>50 %). DS costs account for a high proportion (24.86 %) of total outpatient prescription costs. In addition, pediatric prescriptions containing one DS product (88.16 %) showed a higher rate than prescriptions containing two DS products (11.84 %) with the main ingredients being vitamin D₃ (80.55 %), vitamin B₆ (63.01 %), vitamin B₁ (60.22 %), and vitamin B₂ (59.04 %), and calcium (51.0 %). The majority of DS products contained multivitamins (69.52 %) with DS containing ≥5 vitamins of 59.04 % and DS containing 2–4 vitamins of 10.48 %. Besides, non-compliance with DS prescribing guidelines for age (21.38 %), dose (14.13 %), and both age and dose (5.54 %) was found primarily in highly prescribed DSs (vitamin-amino acid-mineral ingredients), pediatric patients <2 years old, prescriptions containing one DS product or multivitamins, and respiratory disease group (J and R04-09 ICD). The univariate and multivariate regression analyses showed that vitamin-mineral products and groups <2 years old were significantly associated with guideline-adherent DS prescribing for age and/or dose. Meanwhile, foreign DSs and vitamin-mineral ingredients of prescription showed significant associations with guideline-adherent DS prescribing for age or dose.

Conclusion

Instructions for DS use regarding recommended age and maximum dosage may not be carefully considered by doctors due to belonging to an over-the-counter medicine group. Therefore, there is a strong need for a national public policy to prevent and control overprescribing and inappropriate prescribing of DS.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.